- Chondroma reasons
- Chondroma symptoms
- Treatment of a chondroma
The chondroma is a slow-growing benign tumor which grows from cartilaginous tissue. Chondroma арактеризующаяся education mature, usually hyaline, cartilage. It meets in 10 - 12% of cases of all new growths of a skeleton. Typical localization of a chondroma are tubular, the tumor can sometimes affect soft tissues or cartilages of a throat. Cartilaginous tissue is also available in the field of a base of skull and okolonosovy bosoms. When progressing a chondroma it can destroy a bone tissue, and at localization in the field of a base of skull can render a brain prelum. At malignant regeneration the tumor is called a chondrosarcoma. Depending on an arrangement in a bone distinguish central (enchondroma) and peripheral a chondroma (ecchondroma). The chondroma occurs at persons of both sexes and various age. A chondroma of a base of skull can be associated with Olye's disease and a syndrome of Maffuchchi. The chondroma belongs to very rare tumors. Its intracranial localization makes only 0,2-0,3% from all primary intracranial tumors.
The development reasons hondry are unknown.
The tumor is presented by a mature hyaline cartilage with a small amount of elastic fibers, but without collagenic structures. Cells of the usual sizes are located randomly that distinguishes a tumor from a normal cartilage. Sometimes myxomatous changes, the ossification centers meet (formation of marrow). P. von Bruns (1904) for the first time described a trachea osteochondroma. It is important to emphasize that tumors of this type are easily distinguished radiological.
In most cases a chondroma arise in short tubular bones of a brush (70% of cases), is more rare – stop, pelvic bones, vertebras, a breast. Long tubular bones are surprised seldom, in this case the chondroma is located in the metaepiphyseal ends. The chondroma a long time (for years) can not prove in any way. First symptom, as a rule, painless swelling, equal or hilly. Seldom patients are disturbed by pains of stupid character. Deformation of a bone, restriction of mobility of a joint owing to deformation or a pathological change is possible.
The diagnosis of a chondroma is established mainly on the basis of X-ray inspection.
Is usually difficult assured to carry out differential diagnosis with a chondrosarcoma. Mayot D. et al. (1991) described the trachea chondroma which arose against the background of multiple injuries and operations at the patient of 50 years. In 6 months after an oncotomy there was a recurrence with the expressed trachea stenosis. The laryngectomy with a massive resection of a trachea is made. The high-differentiated chondrosarcoma is histologically confirmed. In a year there was a new recurrence in a trachea which is considerably removed. Nevertheless, the patient died of a recurrent tumor in the field of bifurcation.
Difficulties of differential diagnosis hondry are most known at localization of a tumor in a throat and a bronchial tube. The similar chain of a repeated recurrence after economical resections of these bodies was described by the researchers armed with the most advanced methods of morphological diagnosis.
Treatment of a chondroma:
In treatment of a chondroma are applied both surgery, and radiation therapy. The choice of this or that method of treatment of an intracranial chondroma depends on such factors as localization of a tumor, its sizes, the relation to the next fabrics, and also the general condition of the patient, risk of complications and existence of associated diseases. The standard of treatment of a chondroma is the operational method. The operative measure type at a chondroma depends on localization of a tumor and its sizes. Operational treatment can be as open, so low-invasive, endoscopic. Open operation - a craniotrypesis, allows to get access to a tumor by opening of a cranium. The endoscopic method at a chondroma is carried out through endonasal access (through the nasal courses). The endoscopic method has advantage before open operation in respect of much smaller injury for the patient, smaller risk of complications, and shorter postoperative period. From characteristic complications of surgical treatment интракраниальынх hondry bleeding, infection and some other meet.
The chemotherapy is applied at malignant chondrosarcomas. At high-quality hondroma the chemotherapy is not applied as it is inefficient and characterized by high risk of side effects.
Radiation therapy is also applied in treatment hondry bases of skull. It can be applied as before operation, with the purpose to reduce the tumor sizes, and after it, for elimination of perhaps remained tumor cells. Besides, radiation therapy can be applied as an independent method of treatment when an operative measure is contraindicated, for example, at high risk of complications or existence of contraindications, for example, at nonresectable tumors. Radiation therapy is carried out in the form of a course which lasts several weeks. Usually in a week five sessions of radiation are held. From possible complications of radiation therapy beam dermatitis and a hair loss in the field of radiation can meet.
Today radiation therapy even more often gives way to so-called stereotaxic radiation therapy, or radio surgery. The technology of radio surgery includes such methods as a gamma knife, a cyber-knife and новалис. Today it is innovative and modern technology which can be an alternative to surgical intervention. The essence of this method is that the tumor is irradiated with a posterior weak pyramid of radiation every time from the different party. At the same time, through surrounding soft tissues there passes the harmless dose of radiation, and in a tumor the maximum exposure dose concentrates. Process of radiation during all session is constantly controlled by means of KT or MPT, thus, the maximum accuracy of the direction of a bunch of radiation is reached. Therefore the method is also called radio surgery as its effect is similar to an oncotomy without cuts.
The radio surgery has big advantages both before radiation therapy, and before surgical intervention. It is a noninvasive method therefore it is deprived of risk of complications which meet at an operative measure. The method is painless therefore it does not demand any anesthesia that also reduces risk of complications. The radio surgery can effectively be applied in case localization of a tumor does not allow to carry out surgical intervention, or at a serious general condition of the patient when the risk of complications is high. Besides, the patient right after radiation can go home and it does not need the recovery period. The only lack of radio surgery is a restriction on the sizes of a tumor and the fact that the effect of its use occurs not at once, and in several weeks or even months.